BackgroundExpanded access is the use of investigational drugs (IDs) outside of clinical trials. Generally it is performed in patients with serious and life-threatening diseases who cannot be treated satisfactorily with authorized drugs. Legal regulations of expanded access to IDs have been introduced among others in the USA, the European Union (EU), Canada and Australia. In addition, in the USA an alternative to expanded access is treatment under the Right-to-Try law. However, the treatment use of IDs is inherently associated with a (...) number of ethically relevant problems.Main textThe objective of this article is to present a coherent framework made up of eight requirements which have to be met for any treatment use of an ID to be ethical. These include a justified need for the use of an ID, no threat to clinical development of the ID, adequate scientific evidence to support the treatment, patient’s benefit as the primary goal of the use of an ID, informed decision of a patient, fair access of patients to IDs, independent review, as well as the dissemination of treatment results.ConclusionsWhile this framework is essentially consistent with the legal regulations of expanded access of the USA, the EU, Canada and Australia, it is substantially wider in scope because it addresses some important issues that are not covered by the regulations. Overall, the framework that we developed minimizes the risks and threats, and maximizes potential benefits to each of the four key stakeholders involved in the treatment use of IDs including patients, doctors, drug manufacturers, and society at large. (shrink)

Was heißt es, einen literarischen Text zu interpretieren? Wie können Interpretationen begründet werden? Können wir mit Interpretationen Anspruch auf Erkenntnis erheben? Können Interpretationen wahr sein? In welcher Weise fließt das Wissen von Interpreten in ihre Interpretationen ein? Aus der Perspektive verschiedener Disziplinen suchen die Beiträge dieses Bandes Antworten auf diese und andere fundamentale Fragen, die sich mit der Interpretation von Literatur verbinden. Der einleitende Beitrag gibt einen Überblick über wichtige Themen und Probleme, die gegenwärtig im Hinblick auf die Theorie und (...) Praxis der Literaturinterpretation diskutiert werden. Die in den folgenden vier Sektionen versammelten Studien widmen sich unter anderem Fragen nach dem Interpretationsbegriff, der Geltung und der methodisch geleiteten Begründung von Interpretationen, den kognitiven Operationen beim Verstehen und Interpretieren von Literatur sowie den Problemen, die sich in der Praxis der Literaturinterpretation angesichts der spezifischen Beschaffenheit literarischer Texte ergeben. Vertreten sind die Fachgebiete der deutschsprachigen Literaturwissenschaft, Philosophie, Linguistik, Mediävistik, Anglistik und Computerphilologie. [What does it mean to interpret a work of literature? How can interpretations be justified? Can interpretations serve as a source of knowledge? Is it possible for interpretations to be true? How does the knowledge of interpreters contribute to their interpretations? The essays comprised in this volume look for answers to these and other fundamental questions regarding the interpretation of literature. The introduction provides an overview of the main issues and problems in contemporary debates on the theory and practice of interpretation. The articles are grouped into four sections and cover topics like the concept of interpretation, the validity of interpretations, the methods for justifying interpretations, the cognitive processes that are involved in understanding and interpreting literature, and address problems that arise in the practice of interpretation and in light of the specific characteristics of literary texts. The contributors to this volume come from a variety of disciplines such as literary studies, philosophy, linguistics, and the digital humanities.]. (shrink)

There are obvious flaws in REM sleep suppression paradigms that do not allow any conclusion to be drawn either pro or contra the REM sleep-memory hypothesis. However, less intrusive investigations of REM sleep suggest that this sleep stage or its adjunct neuroendocrine characteristics exert a facilitating influence on certain aspects of ongoing memory formation during sleep. [Nielsen; Vertes & Eastman].

Representing the thinking of philosophers, psychologists, sociologists, coaches, and sports writers, these essays bring together a wide range of approaches to ...

Evaluation of clinical ethics support services (CESS) has attracted considerable interest in recent decades. However, few evaluation studies are explicit about normative presuppositions which underlie the goals and the research design of CESS evaluation. In this paper, we provide an account of normative premises of different approaches to CESS evaluation and argue that normativity should be a focus of considerations when designing and conducting evaluation research of CESS. In a first step, we present three different approaches to CESS evaluation from (...) published literature. Next to a brief sketch of the well-established approaches of ‘descriptive evaluation’ and ‘evaluation of outcomes’, we will give a more detailed description of a third approach to evaluation—‘reconstructing quality norms of CESS’—which is explicit about the normative presuppositions of its research (design). In the subsequent section, we will analyse the normative premises of each of the three approaches to CESS evaluation. We will conclude with a brief argument for more sensitivity towards the normativity of CESS and its evaluation research. (shrink)

Freedom of thought is a fundamental human right, enshrined in many human rights treaties. It might very well be the only human right without any practical application. The paper reconstructs scope and meaning of this forgotten right and proposes four principles for its interpretation. In the age of neuroscientific insights and interventions into mind and brain that afford to alter thoughts, the time for the law to define freedom of thought in a way that lives up to its theoretical significance (...) has come. (shrink)

This paper studies intentional action in stit logic. The formal logic study of intentional action appears to be new, since most logical studies of intention concern intention as a static mental state. In the formalization we distinguish three modes of acting: the objective level concerning the choices an agent objectively exercises, the subjective level concerning the choices an agent knows or believes to be exercising, and finally, the intentional level concerning the choices an agent intentionally exercises. Several axioms constraining the (...) relations between these different modes of acting will be considered and discussed. The side effect problem will be analyzed as an interaction between knowingly doing and intentionally doing. Non-successful action will be analyzed as a weakening of the epistemic attitude towards action. Finally, the notion of ‘attempt’ will be briefly considered as a further weakening in this direction. (shrink)

Is knowledge-how, or “practical” knowledge, a species of knowledge-that, or “theoretical” knowledge? There is no comfortable position to take in the debate around this question. On the one hand, there are counterexamples against the anti-intellectualist thesis that practical knowledge is best analysed as an ability. They show that having an ability to ϕ is not necessary for knowing how to ϕ. On the other hand, the intellectualist analysis of practical knowledge as a subspecies of theoretical knowledge is threatened by its (...) own set of counterexamples, which convincingly establish that practical knowledge lacks many of the typical characteristics of theoretical knowledge. Most strikingly it does not even appear to require a belief. In this paper, I develop an account of practical knowledge that avoids these counterexamples. It also manages to preserve both the status of such knowledge as a cognitive achievement and its apparently close conceptual relation to abilities. I start with the counterexamples against the necessity of abilities for practical knowledge and show that they fail because they underestimate the cognitive demands of attempts. I then make use of the logic of dispositions to bridge the gap that counterexamples against the necessity of abilities for practical knowledge open. It is argued that, instead of the ability to ϕ, it is a specific disposition to have the ability to ϕ that constitutes practical knowledge about ϕ. The resulting theory is an anti-intellectualist position that preserves essential intellectualist motivations and thus should be satisfactory for proponents of both views. (shrink)

This paper argues that there are practical problems of such a kind that neither impartial morality nor rational choice theory can provide us with comfort and guidance in our attempt to make the right choice if confronted with such a problem. It argues that both morality and rational choice theory are bound to misconstrue problems of this kind. Appreciating the limits of both morality and rational choice theory, as currently discussed in the literature (Wolf, Morton, Pettit, Hollis & Sugden), enables (...) us to identify the features of these particular practical problems, and allows us to elaborate the idea of an alternative of oneself, which is crucial to a proper understanding of the kind of practical problem the paper draws attention to. (shrink)

We extend stit logic by adding a spatial dimension. This enables us to distinguish between powers and opportunities of agents. Powers are agent-specific and do not depend on an agent’s location. Opportunities do depend on locations, and are the same for every agent. The central idea is to define the real possibility to see to the truth of a condition in space and time as the combination of the power and the opportunity to do so. The focus on agent-relative powers (...) and space-relative opportunities firmly roots effectivity of an autonomous choice making agent in a space–time picture. Our space–time view will be classically Newtonian, since we will assume relativistic phenomena do not play a role in agentive effectivity. We show how our semantics naturally distinguishes between different kinds of histories; histories that reflect real possibilities and histories that reflect counterfactual possibilities. Furthermore, we discuss how the spatial picture sheds light on conceptual problems plaguing the central stit property of ‘independence of agency’. At several points in the article we will emphasise and defend the differences with Belnap’s theory of agency in relativistic branching space–times. (shrink)

§ 219a of the German Penal Code (StGB) – the so-called ban on advertising abortions – has been subject of an increasing legal-political controversy since 2017 and was dropped by legislation in July 2022. This paper examines and reconstructs the extent to which the aforementioned ‘ban on advertising’ was (in–)‌compatible with recognized standards of medical ethics. For this purpose, arguments put forward in public discourse on both sides of the conflict, insofar as they go beyond basic attitudes toward abortion, will (...) be subjected to a plausibility test from the perspective of medical ethics. This will show that (I.) according to the standard understanding of autonomy in medical ethics by Beauchamp and Childress, the provision of information about abortions is not an undue influence, but a necessary precondition for autonomous decisions by pregnant women; that (II.) the feared undesirable social developments after the abolition of § 219a StGB are empirically unfounded and largely implausible; but that on the other hand (iii) a multi-perspective communication landscape with accessible expert information promises to effectively counteract the self- and external stigmatization of unintentionally pregnant women. As a result, this analysis provides two things: a coherent medico-ethical justification for the annulment of § 219a StGB and an argumentative basis for the defense against future efforts to support biopolitical positions by censoring available information. (shrink)

(2002). Normativity as the Key to Objectivity: An Exploration of Robert Brandom's Articulating Reasons. Inquiry: Vol. 45, No. 3, pp. 373-391.

La recherche récente a régulièrement remis en cause la catégorie moderne de « lois sacrées » désignant des inscriptions grecques qui forment un ensemble mal défini. Cet article entend dépasser le corpus traditionnel des « lois sacrées » en présentant un projet de recueil alternatif de « Normes rituelles grecques » (CGRN pour l’acronyme anglais), qui s’appuie sur des critères plus sélectifs et sera publié en ligne.

This paper argues that there are practical problems of such a kind that neither impartial morality nor rational choice theory can provide us with comfort and guidance in our attempt to make the right choice if confronted with such a problem. It argues that both morality and rational choice theory are bound to misconstrue problems of this kind. Appreciating the limits of both morality and rational choice theory, as currently discussed in the literature, enables us to identify the features of (...) these particular practical problems, and allows us to elaborate the idea of an alternative of oneself, which is crucial to a proper understanding of the kind of practical problem the paper draws attention to. (shrink)

We investigate a series of logics that allow to reason about agents' actions, abilities, and their knowledge about actions and abilities. These logics include Pauly's Coalition Logic CL, Alternating-time Temporal Logic ATL, the logic of ‘seeing-to-it-that' (STIT), and epistemic extensions thereof. While complete axiomatizations of CL and ATL exist, only the fragment of the STIT language without temporal operators and without groups has been axiomatized by Xu (called Ldm). We start by recalling a simplification of the Ldm that has been (...) proposed in previous work, together with an alternative semantics in terms of standard Kripke models. We extend that semantics to groups via a principle of superadditivity, and give a sound and complete axiomatization that we call Ldm G. We then add a temporal ‘next' operator to Ldm G, and again give a sound and complete axiomatization. We show that Ldm G subsumes coalition logic CL. Finally, we extend these logics with standard S5 knowledge operators. This enables us to express that agents see to something under uncertainty about the present state or uncertainty about which action is being taken. We focus on the epistemic extension of X-Ldm G, noted E-X-Ldm G. In accordance with established terminology in the planning community, we call this extension of X-Ldm G the conformant X-Ldm G. The conformant X-Ldm G enables us to express that agents are able to perform a uniform strategy. We conclude that in that respect, our epistemic extension of X-Ldm G is better suited than epistemic extensions of ATL. (shrink)

The paper critically engages with some of the normative arguments in Julian Savulescu and Ingmar Persson’s book Unfit for the Future. In particular, it scrutinizes the authors’ argument in denial of a moral right to privacy as well as their political proposal to alter humankind’s moral psychology in order to avert climate change, terrorism and to redress global injustice.

The issues that Paul Standish alerts us to are significant since they situate McDowell's argument in reference to works lying outside the mainstream tradition o.

This paper argues that there are practical problems of such a kind that neither impartial morality nor rational choice theory can provide us with comfort and guidance in our attempt to make the right choice if confronted with such a problem. It argues that both morality and rational choice theory are bound to misconstrue problems of this kind. Appreciating the limits of both morality and rational choice theory, as currently discussed in the literature (Wolf, Morton, Pettit, Hollis & Sugden), enables (...) us to identify the features of these particular practical problems, and allows us to elaborate the idea of an alternative of oneself, which is crucial to a proper understanding of the kind of practical problem the paper draws attention to. (shrink)

Among others, the term problem plays a major role in the various attempts to characterize interdisciplinarity or transdisciplinarity, as used synonymously in this paper. Interdisciplinarity is regarded as problem solving among science, technology and society and as problem orientation beyond disciplinary constraints. The point of departure of this paper is that the discourse and practice of ID have problems with the problem. The objective here is to shed some light on the vague notion of problem in order to advocate a (...) specific type of interdisciplinarity: problem-oriented interdisciplinarity. The outline is as follows: Taking an ex negativo approach, I will show what problem-oriented ID does not mean. Using references to well-established distinctions in philosophy of science, I will show three other types of ID that should not be placed under the umbrella term problem-oriented ID : object-oriented ID, theory-oriented ID, and method-oriented ID. Different philosophical thought traditions can be related to these distinguishable meanings. I will then clarify the notion of problem by looking at three systematic elements: an undesired state, a desired state, and the barriers in getting from the one to the other. These three elements include three related kinds of knowledge: systems, target, and transformation knowledge. This paper elaborates further methodological and epistemological elements of problem-oriented ID. It concludes by stressing that problem-oriented ID is the most needed as well as the most challenging type of ID. (shrink)

In this paper, I provide some evidence for the view that a common charge against those who adopt vegetarianism is that they would be sentimental. I argue that this charge is pressed frequently by those who adopt moral absolutism, a position that I reject, before exploring the question if vegetarianism might make sense. I discuss three concerns that might motivate those who adopt vegetarian diets, including a concern with the human health and environmental costs of some alternative diets, a concern (...) about inflicting pain on animals, and a concern with the killing of animals. While I argue that vegetarianism does not make sense in some situations, I hope that this paper shows that there are many good reasons why the adoption of vegetarian, and—even more so—vegan diets might be appropriate in some situations. In carving out this position, I focus primarily on the question whether a morally relevant distinction between the killing of plants and the killing of animals should be made. I engage primarily with the views of two of the most prominent authors on this issue, arguing that neither Peter Singer nor Tom Regan provide a satisfactory account on the ethics of killing nonhuman organisms. Two views are challenged in particular, the view that relatively simple animals such as molluscs, as well as plants, lack awareness, and the view that animals without a preference to continue living stand to lose little or nothing by being killed. I provide some evidence to support the claim that many share my view that it is more problematic to kill animals than to kill plants, before analyzing why some suppress the negative feelings they associate with killing animals. By exploring these issues I hope to shed some light on the issue of whether the feelings of those who adopt vegetarianism are sentimental or make sense, and to stimulate reflection amongst those with an interest in food ethics. (shrink)

This article argues that Robert Brandom's work can be used to develop ideas in the area of social epistemology. It suggests that this work, precisely because it was influenced by Hegel, can make a significant contribution with philosophical anthropology at its centre. The argument is developed using illustrations from education: the first, from the now classic replication of Piaget's ‘three mountains task’ by Margaret Donaldson and her colleagues; the second, from contemporary debates about the questions of knowledge and epistemic access. (...) This leads to a series of questions concerning the relation of concepts to each other and to objects of knowledge and to the social dimension of epistemology as it is involved in the development of human capacities. (shrink)

The effects of public announcements, private communications, deceptive messages to groups, and so on, can all be captured by a general mechanism of updating multi-agent models with update action models, now in widespread use. There is a natural extension of the definition of a bisimulation to action models. Surely enough, updating with bisimilar action models gives the same result (modulo bisimulation). But the converse turns out to be false: update models may have the same update effects without being bisimilar. We (...) propose action emulation as a notion of equivalence more appropriate for action models, and generalizing standard bisimulation. It is proved that action emulation provides a full characterization of update effect. We first concentrate on the general case, and next focus on the important case of action models with propositional preconditions. Our notion of action emulation yields a simplification procedure for action models, and it gives designers of multi-agent systems a useful tool for comparing different ways of representing a particular communicative action. (shrink)

Research on expert‐novice differences has mainly focused on how experts solve familiar problems. We know far less about the skills and knowledge used by experts when they are confronted with novel problems within their area of expertise. This article discusses a study in which verbal protocols were taken from subjects of various expertise designing an experiment in an area with which they were unfamiliar. The results showed that even when domain knowledge is lacking, experts solve a novel problem within their (...) area of expertise by dividing the problem into a number of subproblems that are solved in a specified order. The lack of domain knowledge is compensated for by using abstract knowledge structures and domain‐specific heuristic strategies. However, the quality of their solutions is considerably lower than the quality attained by experts who were familiar with the type of problem to be solved. The results suggest that when experts are confronted with novel problems as compared with familiar problems, their form of reasoning remains intact, but the content of their reasoning suffers due to lack of domain knowledge. (shrink)

Summary This article examines the complex nature of post-war Italian political thought, stressing the importance of Italy's unusual institutional and historical political arrangements, but also the vibrancy of its political ideologies in this period. In the past it has often been argued that the dysfunctional nature of post-war Italian democracy with its rapidly changing governments, and widespread corruption—which nonetheless coexisted with the one party, the Christian Democrats, being constantly in power—led to the atrophying of political theory in general, and political (...) ideologies in particular. But this picture is strongly disputed here—on the contrary it is argued that Christian Democratic, Left and liberal political ideologies were all complex and interesting. Thus if Christian democracy should ultimately be seen as an ‘ideology of transition’ which existed to help Catholicism adapt to the parameters of modern mass democracy, and which lacked a thinker of the calibre of Jacques Maritain, it nevertheless contained within it important debates on the role of the state, between such interesting thinkers as Giuseppe Dossetti and Alcide De Gasperi. And if anything, political thinking on the Left in the post-war period was even more complex, with visceral debates within the (large) Communist Party (PCI) over whether to work within the law—between such thinkers as Palmiro Togliatti and the Il Manifesto group. Equally on the more revolutionary Left, there were important debates about how quickly capitalism could be made to collapse through revolutionary action between thinkers such as Raniero Panzieri and his more radical disciples, Mario Tronti and Antonio Negri, while later, due to the general failure of these revolutionary efforts, post-modern thinkers such as Gianni Vattimo sought to abandon grand metaphysical narratives, whilst retaining a commitment to Left of centre political commitments. Finally, although not part of a widespread mass movement, the liberal thought of Norberto Bobbio was also highly interesting and sophisticated—borrowing from Hobbes and Kelsen, he sought to advocate a modest form of liberal democracy which allowed for civilised forms of conflict, and the protection of minorities, and which rejected the contention of Marxists that civil rights could not be distinguished from economic ones. Overall, if normative aspirations in post-war Italian politics were often frustrated in practice, this was certainly not due to any lack of theoretical vibrancy. (shrink)

In this paper it is shown that addition of certain reductions to the standard cut removing reductions of deductions in prepositional logic makes prepositional logic non-normalizable. From this follows that some provable propositions in prepositional logic has no direct proof.

Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for Palliative Medicine. Main outcome measures Types (...) and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)